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ObjectiveSpirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection.Study DesignWe conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome.ResultsWithin seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial.ConclusionHigh-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19.Clinical Trial Registrationhttps://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1)

IntroductionThe transition of graduates from various levels of the education system, whether it be from schools or universities, into the labor market has become a significant concern in many countries. This concern arises from the realization that a rising unemployment rate, particularly among educated youth, can have numerous economic and social repercussions for societies. Extensive research conducted by the International Labor Organization (ILO) in 2019 and the CEDEFOP in 2020 has highlighted the critical role of the mismatch between Technical and Vocational Education and Training (TVET) and the demands of the labor market in exacerbating the unemployment crisis in low and middle-income countries. Consequently, recognizing the importance of establishing a harmonious relationship between TVET and workforce employment within the labor market, this study aimed to address the following question: To what extent does a balance or imbalance exist between the representation of TVET and employment in the three key sectors of industry, services, and agriculture within the country? With this objective in mind, this research endeavored to provide an overview of the current state of affairs concerning the presence or absence of equilibrium between TVET and employment within the country, while also underscoring the necessity of revising the educational development process based on the requirements of the labor market within this particular educational subsystem. Materials and MethodsThe present study was an applied research conducted using a quantitative approach and employing a descriptive-analytical method. Secondary research methodology was utilized in this study. The statistical data sources for this study comprised registration statistics of graduates from technical and vocational high schools at the second level, individuals, who have acquired skills through informal training offered by the TVT Organization, as well as graduates from Technical and Vocational Universities and Comprehensive Scientific-Applied Universities during the academic year of 2019/20. These data were categorized according to industry, services, and agriculture clusters. Additionally, data from the labor force census plan in the academic year of 2019/20 were also incorporated. Sampling and data verification processes were conducted using a complete counting approach and all the recorded data were included in the analysis. To address the research questions, descriptive-fuzzy tests, such as averages and standard deviations, were employed, along with inferential tests, such as single-group t-tests, ANOVA, and the TOPSIS and TOPSIS-A methods for data analysis. Discussion of Results & ConclusionThe research findings shed light on the current state of compatibility between employment and technical, vocational, and skill training within the sectors of industry, agriculture, and services of the country. Both the descriptive and fuzzy sections of the study revealed a lack of satisfactory alignment between training and employment nationwide with a significant mismatch observed across all three sectors. Specifically, the results indicated that mismatch existed in all clusters, with industry and agriculture experiencing a more pronounced disparity. The mismatch within the services and agriculture clusters primarily stemmed from a shortage of technical, vocational, and skill graduates in the fields related to these sectors. On the other hand, the imbalance within the industry cluster was attributed to an excess of technical, vocational, and skill training surpassing the demands of the labor market. This discrepancy characterized by a shortage of training in the services cluster and an oversupply of training in the industry cluster reflects a common characteristic of less developed societies. It stands in contrast to prevailing and future employment trends worldwide. Unquestionably, this trajectory will inevitably lead to a crisis of mismatch and a surge in unemployment in the country's labor market. In conclusion, the research findings underscored the urgent need to address the imbalance between training and employment in the country. A comprehensive review and revision of the education system, specifically tailored to meet labor market demands within this particular subsystem, are imperative. By aligning technical, vocational, and skill training with the evolving needs of industries in the country, the nation can navigate towards a more harmonious and prosperous labor market, thereby mitigating the risks associated with mismatch and unemployment in the future.

Iranian higher education has been facing many challenges and problems during its evolution. In such a way that the upcoming challenges and prolems create obstacles on the way to excellence, cause disruption in activities and functions, disturb the balance and coherence, and also reduce its performance and inefficiency in the society in the field that has been different. One of the influential components in the policy making and planning process of the higher education system is to identify and deal with the challenges and problems arising from them, in a conscious, measured way, at the right time, and based on the intellectual foundations and practical and behavioral framework. It is based on truth, rationality and logic. In this regard, the present research aimed to identify the system of higher education economy’s problems and their ranking through a systematic review of scientific and academic texts and semi-structured interviews. It has been done with experts and scientific and operational experts in this field. The current research was in the category of applied research in terms of purpose and descriptive-analytical method. Data and information were analyzed using thematic analysis method and Friedman's test. Based on the analysis of opinions and views of experts, 9 challenges and 23 problems were counted and identified. The results of the Friedman test have also shown that challenges and issues do not have the same importance and priority. Therefore, according to the conditions and needs of society, addressing some of them has more priority than others.

In this paper, the simulation and optimization of a combined supercritical carbon dioxide Brayton cycle, an organic Rankine cycle and multi-effect distillation system driven by solar energy have been applied for power and freshwater generation. In this cycle, the solar collector, the central receiver reflected the sun’s light by heliostats, enters the storage system and then enters the fluid stream according to the amount of heat required to initiate the cycle. The working fluid of solar receiver is a mixture of the 60% NaNO3and 40% KNO3, supercritical carbon dioxide is working fluid of the Brayton cycle and R600 is the working fluid of the organic Rankine cycle. The innovation of this article is using power and fresh water cycle without fuel consumption (with solar system and storage tanks). The simulation of this combined cycle was carried out by engineering equation solver software and energy and exergy efficiency changes in terms of different parameters are obtained. Then, a multi objective optimization of this system considering exergy efficiency and cost of system as objective functions is performed by genetic algorithm in Matlab software. Decision variables of the whole cycles are including Compressor inlet temperature, Turbine inlet temperature, Number of MED effect, The temperature of the water fed the desalination, Evaporator pinch point, Mass flow (Critical Carbon Dioxide), Turbine inlet pressure, Compressor inlet pressure and Pressure drop. The two objective functions optimization including exergy and economic parameters of this cycle is carried out for achieving reduction of electricity generation cost and increase of the exergy efficiency. The results of this optimization showed, the maximum exergy efficiency of this combined system is 61.78% and the minimum cost of electricity production is 0.2617 $/kWh. In this regard, the multiple effect distillation system produces 530.9 KgSfreshwater in 15 stages.

In this study, the effect of using waste saline water on water quality, metabolic and production parameters of Litopenaeus vannamei was evaluated and compared to that of using Caspian Seawater in laboratory conditions. Shrimp with an average weight of 1.38± 0.09 g and 7.12± 0.30 cm were reared in eighteen 50-L plastic tanks (6 treatments, each with 3 replicates) for 30 days. The experimental treatments included two water environments (Wastewater: W and Seawater: S) and three culture densities (L, M, and H, representing15, 30, and 45 shrimp in each tank, respectively). Feed conversion ratio decreased significantly with an increase in density, but there were no significant differences between the several groups (water and density) in terms of growth parameters (the final body weight, weight gain, and specific growth rate). The water ammonia, nitrate, and phosphate concentrations significantly increased with an increase in stocking density. Glucose, protein, and hemocyanin activities increased significantly in WH and WM compared to other treatments. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities were significantly higher in SH compared to other treatments. Generally, these results suggest that the culture of L. vannamei in waste saline water with suitable density (30 shrimp/ 50 L) is possible in laboratory conditions.

This study was carried out to evaluate the effects of adding molasses (in water and diet) on growth performance, digestive enzyme activity and non-specific immunity of Cyprinus carpio in a biofloc system. Common carp (12.06± 0.35 g mean initial weight) were cultured in 3 treatments with triplicate for 7 weeks with daily addition of sugar beet molasses as carbon source to maintain the C/N ratio (1:15) which included: addition molasses to water (MW) and feed (MF) in biofloc system and clean water control without molasses addition (control). There was no statistically significant difference in water quality (ammonia and nitrate) between different experimental treatments. The growth and feed performance were significantly higher in the receiving molasses treatment than the control (P

BACKGROUND: Metabolic syndrome is defined by insulin resistance and a clustering of other cardiovascular risk factors. Crocin is a carotenoid derived from the stigmas of the saffron flower and had previously been shown to affect lipid profile. However, the mechanism for this function is not well understood. The present trial aimed to investigate the possible effect of crocin on plasma levels of cholesteryl ester transfer protein and lipid profile in individuals with metabolic syndrome. METHODS: This was a randomized, double-blind, placebo-controlled, clinical trial consisting of an 8-week treatment with crocin, or placebo tablets between April and June 2014, in the Nutrition Clinic of Ghaem Teaching Hospital, Mashhad, Iran. Participants were randomly assigned to take a 30 mg/day crocin (n = 22) in the intervention group or placebo (n = 22) in the control group. Anthropometric, hematological and biochemical parameters were measured and recorded during pre and post-treatment periods. RESULTS: Whilst plasma cholesteryl ester transfer protein was increased in the group taking the crocin tablet by 27.81% during the trial period (P = 0.013), the difference between the crocin and placebo groups was not significant (P = 0.116). Moreover, the percent changes in cholesterol (P = 0.702), triglyceride (P = 0.080), low-density lipoprotein (LDL) (P = 0.986), high-density lipoprotein (HDL) (P = 0.687) and fasting blood glucose (P = 0.614) did not differ significantly between intervention and control groups. CONCLUSION: Although crocin supplements increased the serum cholesteryl ester transfer protein in patients with metabolic syndrome, this change was not significant between treatment and placebo groups.

Breast cancer that is caused by the accumulation of genetic and epigenetic alterations, is one of the main causes of death resulted from cancer. Various therapeutic approaches have been introduced for this cancer and the traditional diagnosis and treatment is based on the prognosis estimation using cancer anatomic features (TNM system) and clinical results, but studies show different responses of these treatments and recurrence after those in some patients. This diversity is resulted by the differences in biological and molecular characteristics. So genomic and molecular studies became more important and the role of targeted treatment based on an individual's genome was highlighted. Today, the progression in personalized medicine using specific individual genome profile has been possible. The ultimate goal of such studies, in the setting of the personalized medicine, is providing markers which can be used to risk assessment of progressing disease. This new science cause great development in the treatment of breast cancer by recognition of specific markers and application of targeted therapy. Trastuzumab and tamoxifen are the most common monoclonal antibodies applied in these patients depends on their biological and molecular profile. The good response to tamoxifen is seen only in patients with estrogen receptor (ER+) which inhibits the binding of estrogen to its receptor. Defect in the metabolizer enzyme of tamoxifen (CYP2D6), which convert it to the active forms, results in the increased risk of recurrence after treatment. Fulvestrant is another monoclonal antibody which its effect is similar to tamoxifen. Trastuzumab suppresses the cell growth by binding inhibition of epidermal growth factor to HER2 receptors. In the metastatic form of disease, the patients may show resistance to trastuzumab, so lapatinib is suitable alternative in these cases. Pertuzumab combination with trastuzumab and chemotherapy with taxane blocks the dimerization of HER2 with another form of HER receptors. The application of personalized medicine in triple negative phenotype is limited due to the lack of appropriate targets and biomarkers, it makes necessary to do further studies. The aim of this review was to describing the different aspects of personalized medicine and introducing the most important biomarkers and targets in the treatment of breast cancer.

Primary Tuberculous Pyomyositis is a rare manifestation of musculoskeletal tuberculosis especially in immunocompetent individuals without a focus of tuberculosis in the body and the underlying bone disease [1]. We describe a 45 years-old incarcerated immunocompetant man with nontraumatic wound of right thumb since 9 months ago. The diagnosis of tuberculousdactylitis was based on positive acid fast bacilli using Ziehl-Neelson staining and Histopathology from involved skin.

Objective: Spirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of highdose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of highdose Spirulina platensis for SARS-CoV-2 infection. Study Design: We conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome. Results: Within seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-β, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial. Conclusion: High-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to identify and evaluate career guidance curriculum in the world countries. The research method was descriptive and document analysis with comparative approach. The research population consisted of the career guidance curriculum in the countries of the world and the research sample consisted of the career curriculum and work-based education of UK and Australia's Victorian Career Curriculum which were selected purposefully. The model of John Stuart Mill's method of agreement and difference was used. The data collection, document extraction, and data analysis were done using content analysis method. In this study, we described the differences and similarities between the main elements of the curriculum (goals, time, content, teaching-learning, evaluation methods) in the UK's career curriculum and work-based education and Australia's Victorian Career Curriculum. Also, to judge the validity of documents and evidences, the external and internal criticism have been considered. The results of analyzing and comparing the differences and similarities of the main elements of the curriculum (purpose, time, content, teaching-learning methods-assessment) showed that the orientation of both curricula is education with a career-based approach, however, the career curriculum and work-based education covers a wide variety of goals and implementation time, compared to the Victoria Career curriculum. The results of examining the content element in both curricula indicated three stages of personal development, career exploration and career management. Examining the elements of teaching-learning strategies and assessment showed that what is important in both career guidance curricula is the use of new and active methods alongside the traditional methods. Based on the findings of this study, it is suggested to the policy makers of the educational system of Iran to design a career guidance curriculum according to the characteristics of the elements of the career guidance curriculum in successful countries.